Response rate measured by Response Evaluation Criteria in Solid Tumors [ Time Frame: Up to 3 years ] [ Designated as safety issue: No ]

Incidence of adverse events graded according to Common Terminology Criteria for Adverse Events version 4.0 [ Time Frame: Up to 30 days after completion of study treatment ] [ Designated as safety issue: Yes ]

Overall survival (OS) [ Time Frame: From registration to time of death, assessed up to 3 years ] [ Designated as safety issue: No ]

The Kaplan-Meier will be used to estimate the OS curves within each treatment arm.

This randomized phase II trial studies how well everolimus and octreotide acetate with or without bevacizumab works in treating patients with pancreatic neuroendocrine tumors that cannot be removed by surgery and have spread nearby or to other places in the body. Everolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Octreotide acetate may interfere with and slow the growth of tumor cells. Monoclonal antibodies, such as bevacizumab, may interfere with the ability of tumor cells to grow and spread. Bevacizumab and everolimus also may stop the growth of pancreatic neuroendocrine tumors by blocking blood flow to the tumor. It is not yet known whether giving everolimus and octreotide acetate together is more effective with or without bevacizumab in treating pancreatic neuroendocrine tumors.

I. To compare PFS among treatment arms shown to be efficacious. II. To estimate the overall tumor response rate in patients with metastatic pancreatic neuroendocrine tumors treated with one of two novel regimens.

III. To estimate the overall biochemical response rate (as measured by plasma chromogranin A levels) in patients with metastatic pancreatic neuroendocrine tumors treated with these regimens.

IV. To assess the toxicity of each regimen in patients with metastatic pancreatic neuroendocrine tumors.

V. To assess the overall survival of patients with pancreatic neuroendocrine tumors treated with these regimens.

Patients with poorly differentiated neuroendocrine carcinoma or small cell carcinoma are excluded

Documentation from a metastatic disease site is sufficient if there is clinical evidence of a pancreatic primary site

Locally unresectable or metastatic disease

Patients must have either histologic documentation of a pancreatic primary site, or clinical evidence of a pancreatic neuroendocrine primary tumor as determined by the treating physician

Patients with neuroendocrine tumors (e.g., gastrinoma, VIPoma) in whom a pancreatic or peripancreatic primary site is strongly suspected are also eligible

Patients must have evidence of disease (measurable or non-measurable) with evidence of progression within the past 12 months

Measurable disease:

Lesions that can be accurately measured in at least one dimension (longest diameter to be recorded) as >= 2 cm with conventional techniques or as >= 1 cm with spiral computed tomography (CT) scan

Non-measurable disease:

All other lesions, including small lesions (longest diameter < 20 mm with conventional techniques or < 10 mm with spiral CT scan) and truly non-measurable lesions; lesions that are considered non-measurable include the following:

Bone lesions

Leptomeningeal disease

Ascites

Pleural/pericardial effusion

Inflammatory breast disease

Lymphangitis cutis/pulmonis

Abdominal masses that are not confirmed and followed by imaging techniques

Cystic lesions

No prior treatment with bevacizumab, everolimus, or other mammalian target of rapamycin (mTOR) inhibitors

Any prior treatment (with the exception of octreotide) must be completed at least 4 weeks prior to initiation of treatment

Prior treatment with embolization or ablative therapies is allowed if measurable disease remains outside of the treated area

There is no limit on the prior number of procedures

Treatment with somatostatin analogs is a requirement of the study

Patients receiving octreotide at the time of study entry may continue at the same dose level for the duration of the study

Patients not receiving octreotide will initiate treatment according to study guidelines

Prior progression on somatostatin analogs or a negative octreotide scan does not exclude patient participation in this study

Patients should have completed any major surgery >= 4 weeks from start of treatment

Patients must have completed any minor surgery >= 2 weeks prior to start of treatment

Patients must have fully recovered from the procedure

Insertion of a vascular access device is not considered major or minor surgery

Patients should not receive immunization with attenuated live vaccines within one week prior to registration or during protocol therapy

No concurrent condition resulting in immune compromise, including chronic treatment with corticosteroids or other immuno suppressive agents

No active or severe liver disease (e.g., acute or chronic hepatitis, cirrhosis); no positive anti-hepatitis B (HBV); HBV seropositive patients (hepatitis B surface antigen [HBsAg] positive) are eligible if they are closely monitored for evidence of active HBV infection by HBV deoxyribonucleic acid (DNA) testing, and they agree to receive suppressive therapy with lamivudine or other HBV-suppressive therapy until at least 4 weeks after the last dose of everolimus; patients who are hepatitis C antibody positive are eligible provided that hepatitis C viral load (hepatitis C ribonucleic acid [RNA]) is undetectable

No clinical evidence of brain metastases or carcinomatous meningitis

No history of gastrointestinal (GI) perforation within 12 months prior to registration

No history of clinically significant bleeding episodes

Patients on therapeutic anticoagulation are eligible for the study provided that they are on a stable dose of anticoagulants

No uncontrolled diabetes mellitus

Patients with a history of severely impaired lung function as defined as spirometry and diffusing capacity of the lung for carbon monoxide (DLCO) that is 50% of the normal predicted value and/or oxygen (O2) saturation that is 88% or less at rest on room air are excluded